In an earlier blog, I talked about why an early orthodontic assessment with an orthodontist is recommended, from the age of 7 years. One was the problems early loss of baby teeth can cause when underlying adult teeth are not able to erupt due to severe space loss. This article talks about teeth overbites, why and when this should be treated. When most people talk about an overbite, what they are referring to is the horizontal overlap between the upper and lower front teeth.
When an overbite is large, the lower lip gets trapped behind the upper front teeth. If you have observed your child often sucking their lower lip or that the lower lip often appears dry or gets cracked, this may be due to an overbite which makes it difficult for him or her to close her lips normally.
The lower lip sucking or biting pushes the upper front teeth forwards. As a result, the upper lip can also appear more forwards or thicker as a result. This is one of the main reasons why an overbite can worsen over time, or why the upper front teeth can stick out more as time passes.
The 2nd reason, is the larger the overbite, the more likely the front teeth are to be accidentally chipped, knocked or damaged in play with friends or during sport. This can happen in play between friends ie: trampolining, which is a common activity friends do. The knock to the upper front teeth can sensitize the upper teeth, making them more prone to teeth nerve complication injuries in future.
The front tooth on the right side (where the overbite was largest) had a more severe injury, eventually needing root canal treatment
Treating a large overbite early helps prevent further injuries to the adult front teeth.
Overbites are best managed early, before the start of your child’s early teenage growth spurt. The teenage growth spurt can vary from 10-14 years, earlier in girls than boys.
At this stage, guiding the lower jaw forwards to correct an overbite works well, with upper & lower removable bite block plates, worn for a period of 9-12 months full time. At the age of 10-14 years, there are often loose baby teeth present. This can make it difficult to support these plates. For this reason, as well as reducing the risks of chipping or knocking of the adult front teeth, overbites treated between ages 8-10 years have better outcomes.
After (upper & lower jaw guidance plates worn for 12 months)
Note the lower lip is now able to rest comfortably compared with the before photo where it was behind the upper front teeth.
More treatment choices are available at a younger age, particularly orthodontic treatment options that improve both the smile and face/chin balance.
Parents have the impression that braces are often needed after these upper and lower jaw guidance plates. Braces straighten teeth but do not fix jaws, while jaw guidance plates correct the jaw structure but has little effect on teeth movements. What this means is as parents notice a significant overbite correction with the plates, some parents elect not to continue with braces as their son or daughter’s smiles looks so much better after the early treatment and they appear more self-confident at school.
In an older teenager or adult, there is little or no jaw growth available. As such, if the overbite is to be corrected, treatment options range from removing some side teeth to correct the overbite or lower jaw surgery in an adult to bring the lower jaw forwards. What would normally work with removable plates at a younger age tends to be much less effective.
While there are definite risks with jaw surgery (apart from the higher fees), the downsides of removing teeth is sometimes a flattening of the lips can occur after, as the upper front teeth are moved back. This thinning of the upper lips can be significant if the lips are thin to start off with.
In my next blog, I would be talking about Underbites- when is the right time to see an orthodontist for this? This is because for underbites (where the lower front teeth are biting in front of the upper teeth) early treatment timing had a big impact on a successful outcome.
In general, there is a difference in timing about when orthodontists treat jaw structure mismatch between the upper and lower jaws (seen and treated early) and when we straighten teeth (when all or most adult teeth have erupted). Jaw structure size mismatch between the upper and lower jaws, affects the bite and chewing ability, as well as the smile. These should be corrected early before the teenage years of a child, with plates, expanders, distalizers etc. Teeth are usually straightened at an orthodontist when all the adult teeth have erupted- this is generally during the teenage years, usually with braces.